Transcription of Examination and Employment Application
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Print Clear Save STATE OF CALIFORNIA - CALIFORNIA DEPARTMENT OF HUMAN RESOURCES. applications will be processed ONLY for classifications where an Examination / Employment Application Examination is in progress and the published final filing date has not passed, STD. 678 (REV. 12/2017) Page 1 or for vacant positions where a department requests an Application . PRINT OR TYPE--PLEASE SEE INSTRUCTIONS ON BACK PAGE. APPLICANT IDENTIFICATION NUMBER (EASY ID) EASY ID. FIRST 3 LETTERS OF Last 4 DIGITS OF SOCIAL. LAST NAME AT BIRTH MONTH OF BIRTH DAY OF BIRTH SECURITY NUMBER -- APPLICANT'S NAME (Last) (First) ( ) SOCIAL SECURITY NUMBER. MAILING ADDRESS (Number) (Street) E-MAIL ADDRESS WORK TELEPHONE NUMBER. (City) (County) (State) (Zip Code) HOME/VRS/TTY TELEPHONE NUMBER. Examination (S) OR JOB TITLE(S) FOR WHICH YOU ARE APPLYING PERSONNEL. USE ONLY. ANSWER THE FOLLOWING QUESTIONS: 1. Enter the county in which you would like to take the Examination if different from the county of your residence: 2.
All questions must be answered completely and accurately, except as noted. You may be disqualified for any false or misleading statements or for omitting information. The information you furnish will be used to apply for a job, determine your ... attach the Accommodation Request form, you will be contacted via telephone or mail to make specific ...
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